Williams Obstetrics, 26e: Chapter 43 Quiz
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Questions and Answers

What is the term used to describe the separation of the placenta from its implantation site before delivery?

  • Placental spectrum
  • Placental abruption (correct)
  • Placental accreta
  • Placental previa

How does Latin translate the term 'abruptio placentae'?

  • Rending asunder of the placenta (correct)
  • Premature separation of placenta
  • Placenta previa separation
  • Accidental placenta rupture

Which of the following is NOT one of the three placental disorders mentioned in the text?

  • Placenta previa
  • Placental abruption
  • Placenta separation disorder (correct)
  • Placenta accreta spectrum

What is the approximate rate of blood flow through the intervillous space at term, as mentioned in the text?

<p>600 mL/min (A)</p> Signup and view all the answers

Which placental disorder is described as being more common now than in previous years, posing a substantial threat to maternal well-being?

<p>Placental accreta spectrum (A)</p> Signup and view all the answers

'Premature separation of the normally implanted placenta' is described as what?

<p>'Premature separation' term is most descriptive (B)</p> Signup and view all the answers

'Hemorrhage following partial or complete separation of the placenta can be torrential' implies what about this type of hemorrhage?

<p>'Torrential' implies rapid and copious hemorrhage. (A)</p> Signup and view all the answers

Where does the blood and clots dissect to reach in a partial placental abruption?

<p>Between membranes and decidua (D)</p> Signup and view all the answers

What is the main source of blood in a retroplacental hematoma in a nontraumatic placental abruption?

<p>Maternal (B)</p> Signup and view all the answers

What percentage of women with a nontraumatic placental abruption at Parkland Hospital had fetal-to-maternal hemorrhage documented?

<p>20 percent (B)</p> Signup and view all the answers

Why is fetal-to-maternal hemorrhage less common in nontraumatic placental abruptions?

<p>Placental villi are usually initially intact (A)</p> Signup and view all the answers

What is a distinguishing feature of total placental abruption shown on the left in the schematic?

<p>Concealed hemorrhage (C)</p> Signup and view all the answers

Which area does the blood and clots dissect through in a partial placental abruption?

<p>Membranes and decidua (B)</p> Signup and view all the answers

What does the main source of hemorrhage derive from in nontraumatic placental abruptions?

<p>Separation within maternal decidua (C)</p> Signup and view all the answers

What is the initial event likely to trigger placental abruption?

<p>Rupture of a decidual spiral artery (D)</p> Signup and view all the answers

How does a decidual hematoma contribute to placental abruption?

<p>It compresses the adjacent placenta (A)</p> Signup and view all the answers

What condition may predispose some cases of placental abruption according to Brosens, 2011?

<p>Atherosis due to impaired trophoblastic invasion (B)</p> Signup and view all the answers

Why can histological findings not determine the timing of placental abruption?

<p>The abruption process is not reflected in histology (A)</p> Signup and view all the answers

What happens when bleeding insinuates itself between the membranes and uterine wall during placental abruption?

<p>It eventually causes external hemorrhage through the cervix (A)</p> Signup and view all the answers

Why is delayed diagnosis more common in cases of concealed hemorrhage during placental abruption?

<p>'The bleeding is often misinterpreted as normal pregnancy discharge' (A)</p> Signup and view all the answers

Study Notes

Placental Abruption

  • Abruptio placentae is the term used to describe the separation of the placenta from its implantation site before delivery, and it translates to "breaking off" in Latin.
  • It is a type of placental disorder that poses a substantial threat to maternal well-being.

Characteristics of Placental Abruption

  • Premature separation of the normally implanted placenta is a distinguishing feature of placental abruption.
  • Hemorrhage following partial or complete separation of the placenta can be torrential.
  • In a partial placental abruption, the blood and clots dissect through the decidua basalis to reach the intervillous space.
  • The main source of blood in a retroplacental hematoma in a nontraumatic placental abruption is the maternal circulation.

Fetal-to-Maternal Hemorrhage

  • Fetal-to-maternal hemorrhage is less common in nontraumatic placental abruptions due to the separation of the placenta from the maternal circulation.
  • Approximately 14% of women with a nontraumatic placental abruption at Parkland Hospital had fetal-to-maternal hemorrhage documented.

Total Placental Abruption

  • A distinguishing feature of total placental abruption is the complete separation of the placenta from the uterine wall.

Pathophysiology of Placental Abruption

  • The initial event likely to trigger placental abruption is the formation of a decidual hematoma.
  • A decidual hematoma contributes to placental abruption by accumulating between the placenta and uterine wall, causing the placenta to separate.
  • Chronic hypertension may predispose some cases of placental abruption according to Brosens, 2011.

Diagnosis and Complications

  • Histological findings cannot determine the timing of placental abruption.
  • When bleeding insinuates itself between the membranes and uterine wall during placental abruption, it can cause a concealed hemorrhage.
  • Delayed diagnosis is more common in cases of concealed hemorrhage during placental abruption due to the lack of visible bleeding.

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Test your knowledge on hemorrhagic placental disorders as discussed in Chapter 43 of Williams Obstetrics, 26th edition. Questions cover topics such as placental abruption, placenta previa, and placenta accreta spectrum.

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